Samples / NURS FPX 4055 / Assessment 1
Assessment 1: Health Promotion Research
NURS FPX 4055 · Assessment 1
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Health Promotion Research
Harassment in the workplace is now considered to be a common occupational health risk that impacts the whole team, organisation and the entire public health system. For individuals who have been subjected to unwelcome or inappropriate behaviour in the workplace, such as sexual harassment, bullying and discrimination based on race, gender and other protected attributes, there have been many reported instances of psychological and physical harm (Walker, 2025). This assessment is designed to create meaningful health objectives and evidence-based strategies that will help decrease the negative impacts of workplace harassment, while helping to break the silence around seeking help by individuals like Participant B, a fictional employee who represents a growing number of employees facing harassment in the workplace.
Scenario
Participant B is a 31-year-old African-American who works as a customer service team lead for a medium-sized logistics firm. Participant B had been bothered by persistent headaches, high blood pressure measurements and a few weeks of poor sleep and has made an appointment for her employer's occupational health clinic. At intake, the occupational health nurse discovered the following: Participant B's direct shift supervisor has been giving her demeaning comments, excluding her from team decisions, and racist remarks for months. She also shared a situation where a colleague made inappropriate comments about her looks on a regular basis, making her feel uncomfortable leaving the work premises in the evening. Participant B had never actually complained, saying that she didn't want to be targeted and that nothing would happen, as well as that she had seen another colleague come forward about being treated in the same way who was then subjected to greater scrutiny and eventually demoted. She had no clear idea about how to file a complaint of harassment with the company, nor had she received a clear, private discussion of her choices. Participant B spoke about the constant worry about the office, the feeling of guilt for not saying anything for so long, and developed a resentment for an organization that once had faith in her. Like many businesses in the service sector, her job had seen a lot of employee turnover and she felt that the team culture was becoming strained, making her co-worker's environment feel more unsafe to be in than it ever had before.
An In-depth Analysis of a Community Health Concern
Workplace harassment is a major occupational and public health issue that has wide-ranging implications for personal health and well-being, and the work environment. Bullying, sexual harassment, and discriminatory mistreatment are linked to anxiety, depression, burnout, post-traumatic stress symptoms and high cardiovascular risk among those who experience it (Walker, 2025). The issue is not limited to any one harasser or victim, but a systemic lack of psychological safety, the failure to consistently act on complaints and an overall culture of under-reporting, as evidenced by Participant B's experience of being a victim of harassment without a clear or trusted way to get it resolved. Recurrent absenteeism, decreased productivity, increased health care costs and turnover of employees which disrupts knowledge and team structures are organizational consequences of unresolved harassment (Nielsen et al., 2025). The psychological aspect of this issue is significant, as prolonged exposure to mistreatment can lead to enduring distress, a lack of trust in leadership, and the spread of mistreatment among colleagues who have witnessed the negativity but have not experienced it firsthand (Xu et al., 2025). These dynamics create a specific need for occupational health nurses, human resource professionals and organizational leaders to respond in a coordinated and multi-level manner. Re:building trust in organizational systems is a critical component of addressing workplace harassment, particularly among groups that have historically been mistreated and often not adequately protected by their institutions.
Underlying Assumptions and Points of Uncertainty
A key tenet of workplace health promotion is that it will lead to a safer and more respectful workplace when an anti-harassment policy is published and training is mandated on a regular basis. But, as their case, Participant B's suggests, structural power dynamics, fear of retaliation, and inconsistent enforcement are all present, making this assumption highly problematic. However, questions remain about the best way of supporting employees from historically marginalised groups without imposing the burden of proof, disclosure and cultural learning on the employee who is experiencing the problem, thereby exacerbating feelings of isolation and discouraging reporting.
Characteristics of the Chosen Community
A number of striking common trends also emerge regarding the distribution of those who are most likely to be victims of workplace harassment: their jobs are in service industries or hierarchical occupations, they have limited mobility, and they are part of groups that have been historically marginalised at work. According to national survey data from the American Psychological Association (APA), about one in five people in the United States were harassed at work in the past 12 months, and nearly 25% said they had suffered or feared harm to their mental health from their work (APA, 2023). There are many documented racial and ethnic differences in exposure, and a systematic review and meta-analysis revealed a pooled prevalence of 73.6% for exposure to workplace microaggressions across studies reviewed, and a pooled prevalence of 18.8% for exposure to overt racial discrimination across studies reviewed (Salari et al., 2024). Data from industry surveys also indicate that black workers are more likely to say they have been discriminated against on the job or have witness racism in the workplace at twice the rate of all workers (HR Acuity, 2023).
Workers such as Participant B are overrepresented in roles in which they persist in doing work in hostile environments without reporting because they grew up with a sense of structural power imbalance and prior experiences of institutional inaction. In a study studying the effects of chronic exposure to workplace harassment on the development of new mental health outcomes, it has been noted that, over the long term (decades), chronic exposure to work harassment was linked to new mental health problems and to more alcohol use, as it was found to be associated with both new mental health issues and also more alcohol use (Rospenda et al., 2023). Employees in all sectors and of all income levels experience workplace harassment, but the combination of hierarchical power structures, underreporting and organisational mistrust makes workplace harassment particularly complex for those who are already subject to multiple forms of social disadvantage.
Appropriate Examples
The absence of a clear, trusted, and consistently followed reporting process can stifle employees' ability to report mistreatment and result in ongoing psychological harm, as exemplified in the case of Participant B. Her experience is typical of the many service-sector workplaces in which employees are discouraged from making a formal complaint before being silenced by the fear of retaliation. The second example is that of bullying and uncivil behaviour experienced by nurses in the emergency department that often goes unchecked due to the assumption that someone will retaliate unless there is active intervention by nurse leaders and safe reporting practices (Luong & Green, 2023). The cases in this series illustrate how structural and cultural issues continue to persist in efforts to address workplace harassment and underscore the need for psychologically safe, supported reporting systems to tackle these issues.
Importance of Health Promotion
Importantly, health promotion is a key strategy for reducing the negative effects of workplace harassment by addressing the behavioural, organizational and cultural factors that will impact whether or not employees feel safe to disclose workplace harassment and ask for support. A strong health promotion strategy includes providing correct information on what harassment is and how to report it, fostering trust between staff and organizational leadership, engaging with the active bystander and offering trauma-informed support services that are based on lived experiences of the impacted employees. For Participant B and other employees, health promotion could have involved confidential, non-retaliatory reporting systems; planned bystander intervention training for co-workers and supervisors; and private, judgment-free counselling with an occupational health nurse. An analysis of primary-level bystander intervention (BI) programs revealed that employees are more likely to intervene and that impactful bystander interventions help build a culture that reduces harassment before it starts (Nielsen et al., 2025).
The problem of workplace harassment is both widespread and preventable as evidenced by the results of occupational health and organizational psychology research. A systematic review and meta-analysis of workplace violence prevention training programs revealed that structured training resulted in an increase in confidence among healthcare professionals to handle potentially violent behavior, which was more pronounced when the training included simulation and repetition as opposed to lectures alone (Chung et al., 2025). There is evidence based on long-term cohort studies that chronic workplace harassment is a significant factor in the onset of anxiety, depression, and substance misuse and that early, evidence-based intervention is warranted (Rospenda et al., 2023). Other studies have shown that low levels of psychological safety and leadership practices that are not supportive exacerbate the psychological trauma of bullying, whereas leadership that demonstrates the characteristics of ethical and trauma-informed practices can significantly lessen the trauma of bullying (Walker, 2025). These results collectively suggest the need for well-designed, evidence-based health promotion programs that focus on the most vulnerable employees in the workforce with respect to continuing, untreated workplace mistreatment.
Establishing Agreed Upon Health Goals
SMART objectives offer a structure for effective health promotion by making goals specific, measurable, achievable, relevant and time bound. This framework increases the chances of positive results and provides for regular tracking of progress, leading to lasting behavior change and better workplace health results.
By the conclusion of the occupational health counseling session (Time-bound), Participant B will accurately demonstrate knowledge of 5 (Measurable) core workplace harassment concepts including the legal definitions of sexual harassment, bullying, and discrimination, the company's formal reporting procedure, the distinction between generalized workplace conflict and unlawful harassment, available anti-retaliation protections, and appropriate documentation practices (Specific) to support informed, timely decision-making about reporting and to reduce her risk of continued psychological harm (Relevant), increasing her workplace harassment knowledge and confidence scores from a baseline of 40% to at least 90% as measured by a validated pre- and post-training confidence assessment (Achievable).
By the conclusion of the occupational health counseling session (Time-bound), Participant B will identify and engage with a support network of at least 4 (Measurable) trusted resources including the occupational health nurse, the employee assistance program (EAP) counselor, a designated human resources ombudsperson, and a peer support group for employees who have experienced workplace mistreatment (Specific) to address her concerns about retaliation, reduce her isolation, and strengthen her capacity to pursue a formal resolution (Relevant), attending at least two follow-up support sessions within 60 days and reporting a 50% reduction in harassment-related anxiety symptoms as measured by the General Anxiety Disorder-7 (GAD-7) Scale (Achievable).
By the conclusion of the occupational health counseling session (Time-bound), Participant B will complete 6 (Measurable) structured sessions of workplace bystander and peer-advocacy training focused on harassment recognition, safe intervention strategies, and support-seeking communication (Specific) to transform her personal experience navigating workplace harassment into meaningful peer-to-peer support and to strengthen a psychologically safer culture for other employees in comparable situations (Relevant), successfully delivering harassment-awareness presentations to at least 3 workplace teams and distributing accurate reporting resources to a minimum of 40 coworkers, with her advocacy competency measured by a 70% improvement on a standardized Workplace Advocacy Competency Assessment Tool (Achievable).
Conclusion
Workplace harassment is a major and preventable occupational health and safety issue that needs multi-level intervention measures to address the needs of employees and the need for systemic change in structures that create barriers to reporting in a timely and safe manner. As Participant B's case illustrates, silence when experiencing harassment does not necessarily result from passivity, but from overlapping factors of fear of retaliation, institutional power imbalance, and prior institutional mistrust, which all contribute to an inability for an employee to seek out help. There is a need to bring together evidence-based education, trust between employees and their leaders, and psychologically safe reporting systems, to target those who suffer the most from workplace mistreatment and thus are most likely to respond to the effort.
References
American Psychological Association. (2023). 2023 Work in America survey: Workplaces as engines of psychological health and well-being. https://www.apa.org/pubs/reports/work-in-america/2023-workplace-health-well-being
Chung, Y.-F., Chang, Y.-C., Fetzer, S. J., Tessmer, L., Tsai, M.-H., & Feng, J.-Y. (2025). The effectiveness of workplace violence prevention education training programs on healthcare professionals' confidence: A systematic review and meta-analysis. International Nursing Review, 72(4), e70107. https://doi.org/10.1111/inr.70107
HR Acuity. (2023). 2025 Workplace harassment and misconduct statistics: Four gaps that prevent employees from speaking up. https://www.hracuity.com/resources/research/workplace-harassment-and-employee-misconduct-insights/
Luong, A., & Green, C. A. (2023). Mental health and harassment in the workplace. Journal of Emergency Nursing, 49(3), 341–344. https://doi.org/10.1016/j.jen.2022.09.011
Nielsen, K. S., Hansen, M., & Mikkelsen, E. G. (2025). Bystander interventions against gender-based violence and harassment in the workplace: A scoping review. Frontiers in Psychology, 16, e1570812. https://doi.org/10.3389/fpsyg.2025.1570812
Rospenda, K. M., Richman, J. A., McGinley, M., Moilanen, K. L., Lin, T., Johnson, T. P., Cloninger, L., Shannon, C. A., & Hopkins, T. (2023b). Effects of chronic workplace harassment on mental health and alcohol misuse: A long-term follow-up. BioMed Central Public Health, 23(1), e1430. https://doi.org/10.1186/s12889-023-16219-0
Salari, N., Fattah, A., Hosseinian-Far, A., Larti, M., Sharifi, S., & Mohammadi, M. (2024). Prevalence of workplace microaggressions and racial discrimination: A systematic review and meta-analysis. Safety and Health at Work, 15(3), 245–254. https://doi.org/10.1016/j.shaw.2024.05.002
Walker, J. (2025). Trauma, power, and psychological safety: Understanding the mental health impact of workplace bullying. Healthcare, 13(23), e3084. https://doi.org/10.3390/healthcare13233084
Xu, H., Li, Z., Wang, X., Wu, M., Liu, T., & Wu, Q. (2025). Interrelationships of anxiety, burnout, depression, and insomnia among Chinese healthcare workers exposed to workplace violence: A network analysis. Depression and Anxiety, 2025, e9815503. https://doi.org/10.1155/da/9815503